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Emphysematous pyelonephritis (EPN) is a rare lifethreatening infection. It is characterized by the accumulation of gas within the renal parenchyma and surrounding tissues [1]. It typically occurs in the presence of gramnegative facultative anaerobic organisms, such as Escherichia coli (E. coli), Klebsiellaspp. and Proteusspp [2]. In the presence of high tissue glucose levels, these organisms ferment glucose and lactate to carbon dioxide causing necrotizing infection [3]. It is strongly associated with diabetes mellitus (96%) and urinary tract obstruction (29%) [4]. We describe a case of EPN with unique factors. Our patient had bilateral EPN within native non-functioning polycystic kidneys and a functioning renal transplant. Diabetes was diagnosed after renal transplantation concurrently with EPN.

clinical kidney journal

Successful management of bilateral emphysematous pyelonephritis in end-stage polycystic kidneys: bilateral native nephrectomies and preservation of functioning renal transplant